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NEW THIS FRIDAY: SEROEPIDEMIOLOGY OF HEPATITIS E VIRUS INFECTION IN AN URBAN POPULATION IN ZAMBIA

Wednesday, 14th of August 2013

• SEROEPIDEMIOLOGY OF HEPATITIS E VIRUS INFECTION IN AN URBAN POPULATION IN ZAMBIA: STRONG ASSOCIATION WITH HIV AND ENVIRONMENTAL ENTEROPATHY

J Infect Dis. (2013) doi: 10.1093/infdis/jit409 First published online: August 6, 2013

Choolwe Jacobs1,2,

1. 1.     Clarance Chiluba1,
2. 2.     Cynthia Phiri1,
3. 3.     Mpala Mwanza Lisulo1,
4. 4.     Mumba Chomba1,
5. 5.     Philip C. Hill2,
6. 6.     Samreen Ijaz3 and
7. 7.     Paul Kelly1,4

+ Author Affiliations

1. 1.     ¹Tropical Gastroenterology & Nutrition group, UNZA School of Medicine, Lusaka, Zambia
2. 2.     ²University of Otago, New Zealand
3. 3.     ³Virology Reference Laboratory, Health Protection Agency, Colindale
4. 4.     ⁴Blizard Institute, Barts & The London School of Medicine, Queen Mary, University of London, London UK
5. Corresponding author: Dr Paul Kelly, Blizard Institute, Barts & The London School of Medicine, Queen Mary, University of London, London UK, Tel: +44 20 7882 2643, Fax: +44 20 7882 7192, email: m.p.kelly@qmul.ac.uk

Abstract below; full text is at http://jid.oxfordjournals.org/content/early/2013/08/06/infdis.jit409.full.pdf+html

 

Background. Hepatitis E virus (HEV) infection causes major epidemics of infectious hepatitis, with high mortality rates in pregnant women. Recent reports indicate that HEV co-infections with HIV may have a more protracted course. However, the impact of HEV infections in communities heavily affected by HIV remains poorly studied. We set out to examine age-related seroprevalence in a community where we have previously carried out studies on environmental enteropathy.

Methods. Blood samples from 194 children and 106 adults were examined for IgG and IgM antibodies for HEV. HEV data were correlated with HIV status and morphometric analysis of small intestinal biopsies.

Results. Seroprevalence rose throughout childhood, from 8% in children aged 1-4 years, to 36% in children aged 10-14 years. In adults the overall prevalence was 42%, with 28% in HIV seronegative adults and 71% in seropositive adults (OR 6.2; 95%CI 2.2-18; P=0.0001). In adults, villous height and crypt depth measurements showed that HEV seropositivity was associated with worse enteropathy (P=0.05 and 0.005 respectively).

Conclusions. HEV infection is common in Zambia. In adults it is strongly associated with HIV status, and also with environmental enteropathy.

       Received January 19, 2013.

       Revision received June 21, 2013.

       Accepted June 28, 2013.

© The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

 

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.